Pap Smears

The first thing to know about pap smears is that they’re not as bad as you are expecting !

The Papanicolau smear is named after the American pathologist who discovered that by wiping a spatula over a female cervix, spreading that on a glass slide, then looking at it under a microscope he could identify and flag early cell changes that may lead to cancer.

The technique has been adopted round the world as a screening test offered to women in an attempt to reduce the number who contract cancer of the cervix. currently this rate is One in 90 Australian women.

Who should be having a pap smear? In Australia it is currently recommended that all women who are, or have ever been sexually active should have a smear at least every 2 years continuing doing so into their sixties. Of course this may vary depending on the individual case. Especially if you’ve had an abnormality in the past.

Why this this time frame? Research suggests that two years is the average time for cell changes to go from nothing to something.

So what if you’re not sexually active? When should you start? This is a fairly controversial point and probably each case should be assessed on its own merits but... The theory is that exposure to the genital wart virus is a risk factor for cervical cell changes and this is usually sexually transmitted ... You may have been exposed and not ever noticed a wart. However if you've not been ever sexually active your exposure risk is low ... As a rule of thumb many doctors still suggest that by mid twenties is not unreasonable to have a pap smear anyway. .....

So what happens when your doctor   does a Pap smear ?

I like to show women the instruments I use first . We use a speculum which is sort of like a couple of teaspoons hinged at the handles. This is inserted into your vagina. It holds the muscular walls of the vagina slightly apart so your doctor can see your cervix as you lie on your back on an examination couch ...if you are really keen ask your doctor to show you a mirror so you can see for yourself what your cervix looks like.Next your doctor uses a spatula which looks like an icypole stick , to gently wipe over the cervix ...a small amount of cells will freely float off with this wiping. Then a small brush is inserted into the middle canal of the cervix,most women dont feel this to any great degree. And this adds accuracy to the sample . The brush and the spatula are wiped over a glass slide which is then sprayed with a fixative and sent off to the lab.

Believe me the reality is not as bad as this description!  Most doctors take the opportunity to examine your ovaries and uterus at this point by inserting a gloved finger into your vagina and feeling your abdomen at the same time to get an indication of size of these organs.By the way , its also a good time to get your breasts checked and blood pressure taken too.

You shouldn’t have to pay any extra for a pap smear it should be included in the consultation price . At the lab the smear is looked at under a microscope and your doctor usually receives a report with in a week.In Australia the pap smear should not raise a separate fee.

It’s vital that you follow up your results . It frightens me that some women have the smear and never bother to get the results. The Cytology Register is a national list keeping track of trends in Pap results . Women are automatically added to the register but you can opt out. Its a very good idea to remain on the list as your should receive reminders if you miss a smear.

Many women have their pap smear around the time of an annual significant even so they remember - what a birthday present, eh !

As with any screening test it must be remembered that even in the setting of a normal smear persistent symptoms usually warrant further investigations.